Clinical and immunological efficiency of dry carbon dioxide baths in patients with asthma and obesity at the ambulatory-polyclinic stage of rehabilitation

Abstract

Introduction. An important part in the rehabilitation treatment of patients with asthma associated with obesity is the ambulatory-polyclinic stage of rehabilitation that includes drug and physiotherapeutic treatment. Recently, dry carbon dioxide baths (DCDB) are increasingly used.Aim. is to assess the clinical and immunological efficiency of DCDB in the complex rehabilitation treatment of patients with asthma and obesity at the ambulatory-polyclinic stage of rehabilitation.Materials and methods. The study included 60 patients with asthma and obesity admitted to the departments of medical rehabilitation and clinical examination of scientists of the Medical Association of FEB RAS. Patients of the main group (30 subjects) received DCDB and drug therapy. Patients of the comparison group (30 subjects) received only drug therapy. The DCDB procedures were carried out using the “Reabox” device at CO2 concentration of 15-20%, a temperature of 28-30ºC, 10 procedures. The changes in symptoms, ACQ-5 test, and respiratory function were assessed. The parameters of cellular immunity CD3+, CD4+, CD8+, CD16+, CD19+ and the levels of tumor necrosis factor (TNFα), interleukins (IL) IL-2, IL-4, IL-6, IL-10, IL-17A in the blood were analyzed.Results. The achievement of asthma control took less time in patients of the main group. The improvement of bronchial patency was evidenced by the positive dynamics of spirometric indices. After DCDB therapy, an increase in suppressive activity of the cellular immunity, a decrease in the levels of pro-inflammatory cytokine IL-4, IL-17A were revealed. The TNF-α/IL-10 ratio statistically significantly changed due to the increase in the level of anti-inflammatory cytokine IL-10. In the comparison group, the positive dynamics was less pronounced.Conclusion. The use of DCDB increases the clinical and immunological efficiency of the rehabilitation of patients with asthma and obesity at the ambulatory-polyclinic stage. The clinical effect is associated with immunocorrective action, which allows achieving control of the disease in a shorter period of time.\xa0